May 14, 2024; New York, NY, USA; Speaker of the House Mike Johnson (center), and Vivek Ramaswamy (right) look on while former President Donald Trump speaks to the media alongside his lawyer Todd Blanche before his criminal trial at Manhattan criminal court at the New York State Supreme Court on May 14, 2024. Mandatory Credit: Justin Lane/Pool via USA TODAY NETWORK | Justin Lane/Pool via USA TODAY N
Yesterday’s announcement from Donald Trump’s Department of Health and Human Services (HHS) shows just why the 2026 midterms will matter so much, and why the 11 months of waiting to get there could be so disastrous. We need a Congress that will stand up and snatch back the purse strings as the Founding Fathers originally intended.
In the United States Constitution, Congress is granted the power of the purse: the right to decide how much to spend and on what. Also, importantly, it gets to decide when to remove funding. In the 70s, that was used to pull funding from the Vietnam War. That power does not belong with the Executive Branch, which the Constitution says must “take Care that the Laws be faithfully executed.”
Unfortunately, the Founders likely never imagined people like House Speaker Mike Johnson (R-LA) or Senate Majority Leader John Thune (R-SD), who have been willing to roll over and allow Trump to usurp their power, in violation of the basic concepts behind the checks and balances built into the Constitution.
Congress is already working to block gender-affirming care. This week, the House of Representatives passed two gender-affirming care bans for minors, one from Rep. Marjorie Taylor Greene (R-GA) and one from Rep. Dan Crenshaw (R-TX). Those bans are horrific, and we can only pray that the Senate will stop them, but they are at least going through some sort of democratic process.
The Trump administration has a way to move towards a gender-affirming care ban if that is in line with the will of the people and democracy. The HHS proposal doesn’t represent a ban; instead, it’s an end-run on democracy, hoping to conduct a scorched-earth funding pull that they should have no authority to do.
The HHS funding blocking proposal would pull all federal funding from any institution that conducts any gender-affirming care for trans people, even if patients pay for it without using federal funds. Hospitals will have to either comply with the HHS plans by ceasing gender-affirming care or risk losing all federal funding for all other treatments. Major hospital systems have already cut their programs because of these sorts of threats.
Trans youth and their families would be left seeking institutions that only provide gender-affirming care and forgo all government funding, if such a place even exists. Additionally, the removal of Medicaid coverage could see prices rise.
There will certainly be pushback against this plan, especially from cities and states that have marked themselves as trans sanctuaries. But those challenges will take time, and a small interruption in care or even just the threat of it does huge damage to trans youth. Denial of care has been linked to increased rates of depression and anxiety, and for those who have begun puberty, the physical changes that can happen in a short time can be extremely upsetting.
Trump keeps using threats of pulling federal funding to power his authoritarianism. That tactic is only working because Congress isn’t stopping him and saying, “No, that’s our job.” When Nixon pulled federal funds as a way to end programs with the Environmental Protection Agency (a process called impoundment), Congress passed the Congressional Budget and Impoundment Control Act, which closed loopholes and ensured that the president couldn’t rule this way. The Supreme Court went on to rule in 1975 that the president did not have the power to overrule Congress by impounding funds.
Michael Dorf, a constitutional law professor at Cornell University Law School, spoke with ABC News early in the Trump presidency, when he first started using this trick. “If Congress says you’re spending that much money on the federal programs, that’s how much is being spent. The president cannot stop it even temporarily,” he said. “Congress passed this statue this very particular rules of what exactly the president has to do if he wants to not spend money on money Congress has spent. He can ask Congress to for a recission, but there is a 45-day clock and a bunch of procedures, none of which have been followed by Trump.”
Congress’ move here wasn’t just granting itself new powers, but providing a safeguard to ensure that the power of the purse remained where the Constitution had put it. Republicans are quick to wheel out the Constitution and the will of the Founding Fathers, but all of that seems forgotten under Trump. Instead, Congress is leaving decisions to be drawn out in protracted judicial battles, which ultimately run the risk of landing in the Trump-packed Supreme Court.
All of those federal funding threats work well for Trump, as he and his administration can wave their hands and claim that they’re standing by their promise to cut bloated government spending (all while spending millions in taxpayer money on golfing and Kid Rock). But it all relies on a tactic that shouldn’t even be part of the presidential toolkit.
There might be a lot of justifiable hope in 2026 that things will work out. Elections this year have already shown a big swing away from Trump’s party. Republicans are resigning, opening more seats that the party could lose between now and 2027. And while Congress might be voting on gender-affirming care bans themselves, it took a capitulation to a hardline anti-trans Republican as she was heading out the door to get that to happen.
But we’re only halfway to those midterms, and there’s going to be a lot of pain if the current Congress can’t remember why they’re there for another year.
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The state’s ban on gender-affirming pediatric care “cannot be justified” by science, a two-year review concluded.
Madison PaulyMay 27, 2025, 3:00 pm EDT
Spencer Cox of Utah answers a question during a discussion about how our society can learn to disagree in a way that allows us to find solutions on Wednesday, Nov. 15, 2023. | Logan Newell/The Coloradoan / USA TODAY NETWORK
In 2022, Utah Gov. Spencer Cox was the rare Republican governor who seemed to truly care about the well-being of transgender kids. “I don’t understand what they are going through or why they feel the way they do. But I want them to live,” he wrote in a letter that year, explaining why he was vetoing a bill that would have banned four trans middle- and high schoolers in Utah from playing on sports teams with classmates who shared their gender identity. “All the research shows that even a little acceptance and connection can reduce suicidality significantly.”
Meanwhile, nationally, Republican politicians were making opposition to trans rights a core tenet of their platforms, filing hundreds of bills attacking trans kids at the doctor’s office, at school, and on the field. Early in the 2023 legislative session, Cox capitulated, signing a bill that placed an indefinite “moratorium” on doctors providing puberty blockers and hormone therapy to trans kids with gender dysphoria. The bill ordered the Utah health department to commission a systematic review of medical evidence around the treatments, with the goal of producing recommendations for the legislature on whether to lift the moratorium. “We sincerely hope that we can treat our transgender families with more love and respect as we work to better understand the science and consequences behind these procedures,” Cox said at the time.
Now, more than two years later, that review is here, and its conclusions unambiguously support gender-affirming medical care for trans youth. “The conventional wisdom among non-experts has long been that there are limited data” on gender-affirming pediatric care, the authors wrote. “However, results from our exhaustive literature searches have lead us to the opposite conclusion.”
The medical evidence review, published on Wednesday, was compiled over a two-year period by the Drug Regimen Review Center at the University of Utah. Unlike the federal government’s recent report on the same subject, which was produced in three months and criticized gender-affirming pediatric treatments, the names of the Utah report’s contributors are actually disclosed on the more than thousand-page document.
The authors write:
The consensus of the evidence supports that the treatments are effective in terms of mental health, psychosocial outcomes, and the induction of body changes consistent with the affirmed gender in pediatric [gender dysphoria] patients. The evidence also supports that the treatments are safe in terms of changes to bone density, cardiovascular risk factors, metabolic changes, and cancer…
It is our expert opinion that policies to prevent access to and use of [gender-affirming hormone therapy] for treatment of [gender dysphoria] in pediatric patients cannot be justified based on the quantity or quality of medical science findings or concerns about potential regret in the future, and that high-quality guidelines are available to guide qualified providers in treating pediatric patients who meet diagnostic criteria.
In a second part of their review, the authors looked specifically at long-term outcomes of patients who started treatment for gender dysphoria as minors:
Overall, there were positive mental health and psychosocial functioning outcomes. While gender affirming treatment showed a possibly protective effect in prostate cancer in transgender men and breast cancer in transgender women, there was an increase in some specific types of benign brain tumors. There were increased mortality risks in both transgender men and women treated with hormonal therapy, but more so in transgender women. Increase risk of mortality was consistently due to increase in suicide, non-natural causes, and HIV/AIDS. Patients that were seen at the gender clinic before the age of 18 had a lower risk of suicide compared to those referred as an adult.
Submitted with the review was a set of recommendations—compiled by advisers from the state’s medical and professional licensing boards, the University of Utah, and a Utah non-profit hospital system—on steps the state legislature could take to ensure proper training among gender-affirming care providers, in the event it decides to lift the moratorium.
But according to the Salt Lake Tribune, legislators behind the ban are already dismissing the findings they asked for. In response to questions from the Tribune, Rep. Katy Hall, who co-sponsored the 2023 ban, issued a joint statement with fellow Republican state Rep. Bridger Bolinder, the chair of the legislature’s Health and Human Services Interim Committee, that dismissed the study’s findings. “We intend to keep the moratorium in place,” they told the Tribune. “Young kids and teenagers should not be making life-altering medical decisions based on weak evidence.”
Why ignore their own review? Polling, the legislators’ statement suggests. “Utah was right to lead on this issue, and the public agrees—polls show clear majority support both statewide and nationally,” Hall and Bolinder added in their statement. “Simply put, the science isn’t there, the risks are real, and the public is with us.”
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This is some good news at a time when it is in such short supply. At a time when the religious fundamentalist have taken over the republican party in the US forcing the country in to the regressive past, other countries are moving progressively into the future. Hugs
with an emphasis on both physical and mental health for sexually diverse individuals.
Just days after marriage equality became the law in Thailand, the country’s national health ministry added hormone replacement therapy (HRT) to the free health services available to Thai citizens.
On Monday, Thailand’s Public Health Ministry allocated 145.63 million baht to the National Health Security Office for HRT, the Bangkok Post reported. The targeted funds will cover the HRT needs of 200,000 transgender Thais, the ministry estimated.
Deputy government spokesperson Anukool Pruksanusak said the allocation was in direct support of the government’s policy on marriage equality, with an emphasis on both physical and mental health for sexually diverse individuals.
He cited growing acceptance of diverse gender identities and transgender individuals’ reliance on hormone therapy to align their physical appearance with their gender identity for the allocation.
Self-funding for HRT prevented some trans individuals from gaining access to proper care, Pruksanusak said, leading to health risks if they resorted to purchasing and using hormones without medical supervision.
While the new marriage equality law replaces the terms “husband” and “wife” with inclusive, gender-neutral language, resistance to recognizing the full rights of transgender Thai citizens remains in Thailand.
Trans people face “numerous” barriers concerning health, education, work, freedom of movement and non-discrimination, according to Human Rights Watch.
Discrimination based on gender identity and sexual orientation has been illegal in Thailand since 2015, but transgender Thais have no legal avenue to change their gender on official documents.
That resulted last week in many marriages between transgender women and cisgender men that were officially documented as same-sex unions between men.
Transgender woman Nina Chetniphat Chuadkhunthod married her boyfriend of 22 years last Thursday with personal documents that still identify her as male. Thailand’s Parliament rejected a proposed gender recognition bill last February.
“We should use marriage equality as an opportunity to open another door for gender recognition,” said local trans rights advocate Hua Boonyapisomparn.
Nada Chaiyajit, a lecturer at Mae Fah Luang University’s law school, told Reuters, “We have come far in changing the law and there is some way to go for more inclusion.”
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This study is grand. If you read it you will see it debunks the trans haters talking points of lower bone minerals and the complete shown to be false Cass report.
The guidelines also directly push back against claims in the U.K. Cass Review that puberty blockers affect cognition, revealing that they have “no negative effect” on any measures of intelligence or academic success.
The guidelines even provide a definitive rebuke to the claim that puberty blockers cause lower bone mineral density (BMD) by saying, “Trans youth have an average BMD before the onset of puberty that is lower than that of the general population, regardless of treatment. This is probably related to the consequences of dysphoria: less physical activity, eating disorders, and/or poor dietary balance.” After taking the hormones that align with their gender identity, the guidelines’ authors note that trans patients’ BMD is “comparable to that of the experienced gender.”
The guidelines strongly oppose a beloved tactic among anti-trans activists, dubbed the “wait-and-see” approach, wherein medical providers render no care to see if the patient still desires transitional care — the approach has been likened to conversion therapy. The approach, also known as “gender exploratory therapy,” is swiftly criticized by the guideline’s authors who state that it “does not reduce psychological distress.” Instead, it “increases the risk of committing suicide and can affect psycho-affective and cognitive development.”
Medical professionals in France just came out in strong support of gender-affirming care for transgender minors, according to independent trans journalist Erin Reed.
The French Society of Pediatric Endocrinology and Diabetology released a set of guidelines that can be considered the first consensus to come out of France for gender-affirming care. The guidelines were thoroughly conducted: Each section of the review is broken up up into separate categories evaluated by smaller groups of study authors who incorporated input from external experts. The final guidelines were also refined by the broader group of authors.
Trans youth in states that enacted anti-trans laws had up to a 72% increase in suicide attempts.
The authors and studies in the report unequivocally support gender-affirming care, backing puberty blockers and hormone replacement therapy for trans minors. The approach to care they suggest is individualized and evidence-based, promoting the right of trans youth to explore their gender identity and find where they fit in on their own time. By allowing youth to transition early, some elect to skip future surgeries entirely, the study said.
The guidelines strongly oppose a beloved tactic among anti-trans activists, dubbed the “wait-and-see” approach, wherein medical providers render no care to see if the patient still desires transitional care — the approach has been likened to conversion therapy. The approach, also known as “gender exploratory therapy,” is swiftly criticized by the guideline’s authors who state that it “does not reduce psychological distress.” Instead, it “increases the risk of committing suicide and can affect psycho-affective and cognitive development.”
A study published in September shows that anti-trans laws increase the likelihood of suicide by upwards of 72%, suggesting that attempts at implementing these bans on care and advocacy for the “wait-and-see” approach are only harming transgender individuals.
The guidelines even provide a definitive rebuke to the claim that puberty blockers cause lower bone mineral density (BMD) by saying, “Trans youth have an average BMD before the onset of puberty that is lower than that of the general population, regardless of treatment. This is probably related to the consequences of dysphoria: less physical activity, eating disorders, and/or poor dietary balance.” After taking the hormones that align with their gender identity, the guidelines’ authors note that trans patients’ BMD is “comparable to that of the experienced gender.”
The guidelines also directly push back against claims in the U.K. Cass Review that puberty blockers affect cognition, revealing that they have “no negative effect” on any measures of intelligence or academic success.
The French guidelines are especially detailed in that they contain information on how trans youth can alleviate dysphoria as well. They discuss binding techniques, how transfeminine people can tuck, and how to best treat youth in varying stages of their transition.
Editor’s note: If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. The Trans Lifeline (1-877-565-8860) is staffed by trans people and will not contact law enforcement. The Trevor Project provides a safe, judgement-free place to talk for youth via chat, text (678-678), or phone (1-866-488-7386). Help is available at all three resources in English and Spanish.
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Faefyx Collington (They/Them)December 21, 2025, 4:41 pm ESTMay 14, 2024; New York, NY, USA; Speaker of the House Mike Johnson (center), and Vivek Ramaswamy (right) look on while former President Donald Trump speaks to the media alongside his lawyer Todd Blanche before his criminal trial at Manhattan criminal court at the New York State Supreme Court on May 14, 2024. Mandatory Credit: Justin Lane/Pool via USA TODAY NETWORK | Justin Lane/Pool via USA TODAY N
Spencer Cox of Utah answers a question during a discussion about how our society can learn to disagree in a way that allows us to find solutions on Wednesday, Nov. 15, 2023. | Logan Newell/The Coloradoan / USA TODAY NETWORK
Scottie's Playtime 